1. Effective with date of service July 1, 2011, the ONLY immunization administration codes covered for Medicaid recipients in the Health Check age range, 0 through… Read More »North Carolina Medicaid – Billing Guidelines for Vaccines
Cyanocobalamin (Vitamin B-12 injections, J3420) is reimbursed by Medicaid at the point of sale (without prior authorization) for dialysis patients only. However, if the patient has… Read More »Florida Medicaid requires Prior Authorization for B12 Injections
The Medicaid fiscal agent completed required coding for vaccine administration codes 90460, 90471, and 90472 for the Affordable Care Act enhanced rate. Physicians must bill… Read More »Increased Medicaid Fee amounts for Vaccines
Medicaid reimburses licensed, Medicaid-participating hospitals for inpatient services. The services must be provided under the direction of a licensed physician or dentist. Medicaid reimbursement for… Read More »Florida Medicaid Reimbursement for Inpatient Hospital Services
Outpatient hospital services are preventive, diagnostic, therapeutic or palliative care, and service items provided in an outpatient setting. The services must be provided under the… Read More »Florida Medicaid Reimbursement for Outpatient Hospital Services
Health and Human Services (HHS) Secretary Kathleen Sebelius announced the final rule on November 01, 2012 implementing the part of the health care law that… Read More »Medicaid Providers will receive reimbursements at Medicare Levels
Health and Human Services (HHS) Secretary Kathleen Sebelius announced the final rule on November 01, 2012 implementing the part of the health care law that… Read More »Medicaid Providers will receive reimbursements at Medicare Levels
Beginning August 1, 2012, reimbursement for procedure codes 99201-99215 is limited to two per month for general services. This affects the following provider types and… Read More »Florida Medicaid will reimburse only 2 Office visits (99201-99215) per month
After providing a service to a dually-eligible recipient, the provider sends a claim to its Medicare carrier or intermediary. After Medicare processes the claim, it… Read More »How Medicaid Receives Crossover Claims
Medicare has paid the claim in an amount that equals or exceeds Medicaid’s fee for the specified service; The combined amount received from Medicare and… Read More »Medicaid will not pay a crossover claim if: